Midwifery care measures in the second stage of labor and reduction of genital tract trauma at birth: A randomized trial

Leah L. Albers, Kay D. Sedler, Edward J. Bedrick, Dusty Teaf, Patricia Peralta

Research output: Contribution to journalArticlepeer-review

159 Scopus citations

Abstract

Genital tract trauma after spontaneous vaginal childbirth is common, and evidence-based prevention measures have not been identified beyond minimizing the use of episiotomy. This study randomized 1211 healthy women in midwifery care at the University of New Mexico teaching hospital to 1 of 3 care measures late in the second stage of labor: 1) warm compresses to the perineal area, 2) massage with lubricant, or 3) no touching of the perineum until crowning of the infant's head. The purpose was to assess whether any of these measures was associated with lower levels of obstetric trauma. After each birth, the clinical midwife recorded demographic, clinical care, and outcome data, including the location and extent of any genital tract trauma. The frequency distribution of genital tract trauma was equal in all three groups. Individual women and their clinicians should decide whether to use these techniques on the basis of maternal comfort and other considerations.

Original languageEnglish (US)
Pages (from-to)365-372
Number of pages8
JournalJournal of Midwifery and Women's Health
Volume50
Issue number5
DOIs
StatePublished - Sep 2005
Externally publishedYes

Keywords

  • Childbirth
  • Genital tract trauma
  • Midwifery
  • Perineal management
  • Perineal trauma

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Maternity and Midwifery

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